Dan Neville (Limerick, Fine Gael) | Oireachtas source

I thank the Ceann Comhairle for allowing me raise this issue and I thank Minister of State for coming to the House to respond. People with severe and enduring mental illness can experience a range of problems which results in their lives becoming restricted and impoverished. Difficulties arise as a direct result of the disorder, and persistent symptoms can cause distress for the individual and for those around them. Medication can have disabling side effects, while non-compliance can lead to disengagement from prescribed treatment, causing likely collapse. This leads to a loss of self-confidence and sense of purpose in life, institutionalisation, social isolation and housing difficulties. This group of service users is perhaps the most vulnerable in the mental health services, and ultimately the quality of the service overall can be measured by the quality of care provided to this group. In the past this group reflected limitations in professional appreciation of their emotional and practical needs and limited appreciation of their potential to grow and develop as individuals through and beyond the experience of severe mental illness.

A Vision for Change, the report of the expert group on mental health policy, states that rehabilitation and recovery mental health teams should provide a specialised service for people disadvantaged by a range of problems which can develop with severe mental illness and which cannot be adequately dealt with by the general adult community mental health teams. It is important that a process is introduced which enables disadvantaged individuals to access as independent a life as possible in social, cultural and economic terms. A strong commitment to the principle of recovery should underpin the work of the rehabilitation team. This reflects the belief that it is possible for all service users to achieve control over their lives, recover their self-esteem and move towards building a future life where they experience a sense of belonging and participation. Many of this group experienced substantial distress resulting from persistent symptoms, institutionalisation and loss of selfhood, and require individualised specialised interventions with appropriate recovery-oriented programmes. Many could reach a level of functioning sufficient to live and enjoy a more independent life in the community.

The needs of service users with enduring mental illness for social as well as clinical recovery is not addressed by the service provision. Many of the vocational and training programmes which are a key component of rehabilitation and recovery do not meet the needs of service users for moving into mainstream employment. There is a lack of adequate housing and accommodation options to enable service users move through the difficult stages of recovery and progress towards the goal of independent community-based living. A Vision for Change recommended assigning a rehabilitation and recovery community mental health team to population groups of 100,000. Assertive outreach teams providing community-based interventions should be the principal modality through which these teams work.

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